Condition Guide · Medication required
Hypertension VA rating 2026 — 38 CFR §4.104 DC 7101
Updated June 2026 · CFR source: 38 CFR §4.104
Hypertension is one of the most commonly claimed cardiovascular conditions. It is rated under Diagnostic Code 7101 based on blood pressure readings — specifically diastolic and systolic thresholds measured "predominantly" across multiple readings. Veterans on continuous medication for blood pressure control receive a minimum 10% rating.
Rating schedule — DC 7101
| Rating | 2026 monthly | Criteria |
|---|---|---|
| 60% | $1,435.02 | Diastolic pressure predominantly 130 or more. |
| 40% | $795.84 | Diastolic pressure predominantly 120 or more. |
| 20% | $356.66 | Diastolic ≥110 predominantly; or systolic ≥200 predominantly. |
| 10% | $180.42 | Diastolic ≥100 predominantly; or systolic ≥160 predominantly; or minimum evaluation for controlled hypertension requiring continuous medication. |
The "predominantly" standard
VA requires blood pressure readings to be "predominantly" at the threshold level — meaning on most or the majority of readings, not just an isolated high reading. Bring a log of blood pressure readings taken at home or in clinical settings to your C&P exam. Multiple readings over weeks are more persuasive than one exam-day reading.
Service connection and secondary connections
Direct service connection for hypertension requires documented high blood pressure during service or within one year of separation. Common secondary connections:
- Hypertension secondary to PTSD — chronic stress activates the sympathetic nervous system, elevating blood pressure over time.
- Hypertension secondary to obstructive sleep apnea — intermittent hypoxia during apneic episodes triggers hypertension.
- Hypertension secondary to renal (kidney) disease — if SC kidney condition causes blood pressure elevation.
C&P exam — what to bring and document
The hypertension C&P exam centers on blood pressure readings and treatment history. Prepare as follows:
- Bring a blood pressure log. Record home readings over several weeks before your exam — date, time, systolic/diastolic, and conditions (resting, post-activity). Multiple readings showing consistently elevated BP are more persuasive than a single exam-day reading.
- The "predominantly" standard is key. The examiner must find your BP predominantly at the threshold level. Home readings taken at various times of day, across multiple weeks, establish the consistent pattern VA requires.
- Medication records. Bring a list of all antihypertensive medications (current and past). Veterans requiring continuous medication for control receive a minimum 10% rating under DC 7101 even if BP is controlled — document your medication clearly.
- Document secondary condition links. If claiming hypertension secondary to PTSD or sleep apnea, bring the nexus letter from your physician and any records connecting the onset of hypertension to the SC condition.
- Cardiovascular history. Any history of heart failure, ejection fraction results, or cardiac workload testing may support a 40%–60% rating under the higher thresholds of DC 7101.
Secondary conditions from hypertension
Hypertension can cause secondary conditions that are separately ratable:
- Ischemic heart disease (DC 7005) — coronary artery disease caused by hypertension.
- Stroke residuals — cerebrovascular events caused by hypertension.
- Chronic kidney disease — hypertensive nephropathy.
FAQ
What blood pressure reading qualifies for a 10% VA rating?
Diastolic pressure predominantly 100 or more, OR systolic pressure predominantly 160 or more, OR a minimum evaluation for anyone with a history of diastolic predominantly 100+ who requires continuous medication for control. "Predominantly" means on most measurements — not just one reading.
Can hypertension be secondary to PTSD or sleep apnea?
Yes. Secondary service connection for hypertension is well-established when caused by PTSD (chronic stress response elevating blood pressure) or sleep apnea (intermittent hypoxia increasing cardiovascular strain). A physician nexus letter connecting the hypertension to the SC condition is required.
Does hypertension medication reduce my rating?
No — DC 7101 includes a minimum evaluation for veterans who require continuous medication for control of hypertension, even if controlled. Being on anti-hypertensive medication is not used to reduce your rating; the underlying condition remains service-connected.
Can I get both a hypertension rating and an ischemic heart disease rating?
Yes. Hypertension (DC 7101) and ischemic heart disease (DC 7005) are separate diagnostic codes for separate conditions. If hypertension caused ischemic heart disease, the heart disease can be claimed as a secondary condition and rated separately. The two ratings are combined using the standard §4.25 formula.
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